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Updates on Neurostimulation: From Mechanistic Principles to Clinical Applications

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: 25 June 2024 | Viewed by 2480

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Special Issue Editors

Dr. Jose Gomez Tames

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Guest Editor

Department of Medical Engineering, Graduate School of Science and Engineering, Chiba University, Chiba 263-8522, Japan
Interests: neural engineering; brain stimulation; electromagnetics; neuroscience

Dr. Mariano Fernández-Corazza

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Guest Editor

LEICI Institute, National University of La Plata, CONICET, La Plata 1900, Argentina
Interests: electromagnetic modeling; brain stimulation; electroencephalography; electrical impedance tomography

Special Issue Information

Dear Colleagues,

Neurostimulation techniques offer a therapeutic alternative to pharmacological treatments in neurological disorders, including those disorders that are resistant to current treatments. These techniques include non-invasive brain stimulation, such as transcranial electrical stimulation (tES) and transcranial magnetic stimulation (TMS); invasive brain stimulation, such as deep brain stimulation (DBS); or peripheral stimulation, such as vagus nerve stimulation (VNS) and spinal cord stimulation (SCS). Neurostimulation can also serve as a diagnostic tool, such as in-depth electrical stimulation mapping (DESM) for drug-resistant epilepsy patients. Neuromodulation research has experienced significant growth in the last 20 years, and better treatments and new clinical applications are expected in the following years. Optimizing neuromodulation to favor clinical responses is an ongoing work.

However, the physiological mechanisms underlying neurostimulation are not yet fully understood. Measuring neurophysiological responses to stimulation (magnetoencephalography (MEG), functional magnetic resonance imaging (fMRI), or electroencephalography (EEG), electromyography (EMG), among others) can help us to better understand the neurological mechanism and main factors contributing to better clinical outcomes. Computational physics has also permitted quantifying and determining the interaction of physical quantity (i.e., induced electric field) on the target neural elements as the basis of the neuromodulation process, while optimizing the simulation parameters.

This Special Issue welcomes advances in understanding the mechanistic foundations of neurostimulation, proposals of novel or enhanced methodologies, and clinical applications through in vivo, in vitro, ex vivo, in silico and simulation studies. Original research articles and systematic reviews/meta-analyses are welcomed.

Dr. Jose Gomez Tames
Dr. Mariano Fernández-Corazza
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

brain stimulation
non-invasive brain stimulation
deep brain stimulation
neuroimaging
computational modelling
therapy

Published Papers (3 papers)

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Research

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21 pages, 4224 KiB

Open AccessArticle

Comparative Analysis of High-Frequency and Low-Frequency Transcutaneous Electrical Stimulation of the Right Median Nerve in the Regression of Clinical and Neurophysiological Manifestations of Generalized Anxiety Disorder

by Mustafa Al-Zamil, Natalia G. Kulikova, Inessa A. Minenko, Irina P. Shurygina, Marina M. Petrova, Numman Mansur, Rufat R. Kuliev, Vasilissa V. Blinova, Olga V. Khripunova and Natalia A. Shnayder

J. Clin. Med. 2024, 13(11), 3026; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm13113026 - 21 May 2024

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Abstract

Background/Objectives: The anxiolytic effect of transcutaneous electrical nerve stimulation (TENS) is associated with the activation of endogenous inhibitory mechanisms in the central nervous system. Both low-frequency, high-amplitude TENS (LF-TENS) and high-frequency, low-amplitude TENS (HF-TENS) are capable of activating opioid, GABA, serotonin, muscarinic, and cannabinoid receptors. However, there has been no comparative analysis of the effectiveness of HF-TENS and LF-TENS in the treatment of GAD. The purpose of our research was to study the effectiveness of direct HF-TENS and LF-TENS of the right median nerve in the treatment of patients with GAD compared with sham TENS. Methods: The effectiveness of direct HF-TENS and LF-TENS of the right median nerve in the treatment of GAD was studied using Generalized Anxiety Disorder 7-item scale (GAD-7) and the Hamilton Anxiety Rating Scale (HAM-A). 40 patients underwent sham TENS, 40 patients passed HF-TENS (50 Hz—50 μs—sensory response) and 41 patients completed LF –TENS (1 Hz—200 μs—motor response) for 30 days daily. After completion of treatment, half of the patients received weekly maintenance therapy for 6 months. Electroencephalography was performed before and after treatment. Results: Our study showed that a significant reduction in the clinical symptoms of GAD as assessed by GAD-7 and HAM-A was observed after HF-TENS and LF-TENS by an average of 42.4%, and after sham stimulation only by 13.5% for at least 2 months after the end of treatment. However, LF-TENS turned out to be superior in effectiveness to HF-TENS by 51% and only on electroencephalography leads to an increase in PSD for the alpha rhythm in the occipital regions by 24% and a decrease in PSD for the beta I rhythm in the temporal and frontal regions by 28%. The prolonged effect of HF-TENS and LF-TENS was maintained without negative dynamics when TENS treatment was continued weekly throughout the entire six-month observation period. Conclusions: A prolonged anxiolytic effect of direct TENS of the right median nerve has been proven with greater regression of clinical and neurophysiological manifestations of GAD after LF-TENS compared to HF-TENS. Minimal side effects, low cost, safety, and simplicity of TENS procedures are appropriate as a home treatment modality. Full article

(This article belongs to the Special Issue Updates on Neurostimulation: From Mechanistic Principles to Clinical Applications)

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19 pages, 4396 KiB

Open AccessArticle

Efficacy of Non-Invasive Brain Stimulation for Treating Depression in Patients with Traumatic Brain Injury: A Meta-Analysis and Meta-Regression of Randomized Controlled Trials

by Chun-Hung Chang, Po-Han Chou, Hao-Yu Chuang, Chi-Yu Yao, Wei-Jen Chen and Hsin-Chi Tsai

J. Clin. Med. 2023, 12(18), 6030; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12186030 - 18 Sep 2023

Cited by 2 | Viewed by 1265

Abstract

Objective: This meta-analysis aimed to ascertain the efficacy of non-invasive brain stimulation (NIBS)—comprising repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS)—for depression in traumatic brain injury (TBI) patients. Methods: Comprehensive searches were conducted in PubMed, Cochrane Database of Systematic Reviews, and the Cochrane Central Register of Controlled Trials up to 28 January 2023. Random-effects models assessed the treatment effects, and heterogeneity was evaluated through I² statistics and funnel plot inspection. Results: From 10 trials (234 participants; 8 rTMS, 2 tDCS), NIBS was found significantly more effective than sham in alleviating depressive symptoms (SMD: 0.588, 95% CI: 0.264–0.912; p < 0.001). rTMS, specifically, showed higher efficacy (SMD: 0.707, 95% CI: 0.306–1.108; p = 0.001) compared to sham, whereas tDCS outcomes were inconclusive (SMD: 0.271, 95% CI: −0.230 to 0.771; p = 0.289). Meta-regression found no correlation with the number of sessions, treatment intensity, or total dose. Notably, while post-treatment effects were significant, they diminished 1–2 months post intervention. Adverse events associated with NIBS were minimal, with no severe outcomes like seizures and suicide reported. Conclusions: rTMS emerged as a potent short-term intervention for depression in TBI patients, while tDCS findings remained equivocal. The long-term efficacy of NIBS is yet to be established, warranting further studies. The low adverse event rate reaffirms NIBS’s potential safety. Full article

(This article belongs to the Special Issue Updates on Neurostimulation: From Mechanistic Principles to Clinical Applications)

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Review

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32 pages, 2270 KiB

Open AccessReview

Perspectives on Optimized Transcranial Electrical Stimulation Based on Spatial Electric Field Modeling in Humans

by Jose Gomez-Tames and Mariano Fernández-Corazza

J. Clin. Med. 2024, 13(11), 3084; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm13113084 - 24 May 2024

Viewed by 230

Abstract

Background: Transcranial electrical stimulation (tES) generates an electric field (or current density) in the brain through surface electrodes attached to the scalp. Clinical significance has been demonstrated, although with moderate and heterogeneous results partly due to a lack of control of the delivered electric currents. In the last decade, computational electric field analysis has allowed the estimation and optimization of the electric field using accurate anatomical head models. This review examines recent tES computational studies, providing a comprehensive background on the technical aspects of adopting computational electric field analysis as a standardized procedure in medical applications. Methods: Specific search strategies were designed to retrieve papers from the Web of Science database. The papers were initially screened based on the soundness of the title and abstract and then on their full contents, resulting in a total of 57 studies. Results: Recent trends were identified in individual- and population-level analysis of the electric field, including head models from non-neurotypical individuals. Advanced optimization techniques that allow a high degree of control with the required focality and direction of the electric field were also summarized. There is also growing evidence of a correlation between the computationally estimated electric field and the observed responses in real experiments. Conclusions: Computational pipelines and optimization algorithms have reached a degree of maturity that provides a rationale to improve tES experimental design and a posteriori analysis of the responses for supporting clinical studies. Full article

(This article belongs to the Special Issue Updates on Neurostimulation: From Mechanistic Principles to Clinical Applications)

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